This invention relates to analysis and reporting of performance of service providers.
Hospitals, for example, can remain competitive only by frequent analysis of their cost and revenue performance versus competitors. Hospitals typically hire staff analysts or contract with consultants to provide such analyses. The work is usually based on a combination of publicly available and internal patient and financial data, and ends with a formal written report to the hospital's administration. The cost and time for doing the report is often high.
One excellent public source of data is the Healthcare Finance Administration (HCFA) of the federal government. HCFA has created a diagnosis classification system for use in administering Medicare claims. Costs and charges for every hospital in the United States fall into one of twenty-five departments, such as "Operating Room" or "Anesthesiology." A list of the twenty-five departments is attached as FIG. 5. A small portion of the type of data generated by the HCFA, which can be attained by submitting form MCR-2552 to the HCFA, is shown in Table I.
Even more detailed patient information is available from many individual state governments. For example, the state of Massachusetts makes available yearly information on every healthcare patient in the state. Included in this state-provided information are demographic data, such as the age, sex, race, and home zip code of each patient; clinical data, such as length of stay and discharge date for each patient; and charge data, including total amount charged by the healthcare provider for services rendered. All patient information provided by the state of Massachusetts is divided into forty-two healthcare charge categories. Each charge category represents a group of services provided by the healthcare industry and can be linked to one of the twenty-five federally defined departments discussed above. A list of the forty-two charge categories defined by the state of Massachusetts is attached as FIG. 4. Patient level information is available from the Rate Setting Commission of the Commonwealth of Massachussetts.